Provider Demographics
NPI:1376837369
Name:FREEDOM HOMES RECOVERY CENTER LLC.
Entity Type:Organization
Organization Name:FREEDOM HOMES RECOVERY CENTER LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:BA, QP
Authorized Official - Phone:336-512-6454
Mailing Address - Street 1:217 TROLLINGER ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-2225
Mailing Address - Country:US
Mailing Address - Phone:336-233-4294
Mailing Address - Fax:
Practice Address - Street 1:2250 PINE KNOLL TER
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-3177
Practice Address - Country:US
Practice Address - Phone:336-512-6454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility